Rash is a great pretender

Clinical Scenario

A 45-year-old man presents with a scattered rash of red, scaly spots, 0.5–1 cm in diameter on both palms (Figure 1). 

The rash has been present over the last month and appears to be confined to the palms. 

He migrated from Indonesia two years ago. He is married with two children but has occasional unprotected male-to-male sexual encounters. 

What is the diagnosis that comes to mind?
Figure 1: Palmar rash reminiscent of ‘copper pennies’ in secondary syphilis.

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